exploring the concept of empathy in nursing

Core conditions are considered to be of equal importance as they are all required to allow an individual to reconnect with their ‘true self’ and move forward in their lives in their own individual way. Empathy within the counselling relationship involves unconditional positive regard and congruence which essentially means that the focus is on enabling the individual to become self-directed; this is termed ‘Non-directive Counselling’ as there is no hidden agenda (Rogers, 1951). The problem with new initiatives to measure or monitor compassion or empathy is that both of these concepts are considered to be central to a nurse’s identity. Some of the latest initiatives aimed at improving the patient’s experience include teaching nurses to be more empathic (Yu and Kirk, 2008). Counsellors rarely document detailed personal information relating to their work with their clients in order that they can maintain their clients’ privacy. Compare and contrast the key behaviors that support empathy development among nurse High profile new initiatives to improve patient care that also improve the public relations need to be carefully examined. HHS The concept of empathy lies amid much confusion. The term empathy originates from the German word Einfühlung and was first used by Robert Vischer in 1873 to describe the projection of human feeling on to the natural world. By listening and communicating we can understand and guide our patients. An initial review of the literature provides insight into an elusive concept because the researcher can discover what is known, not known, or confusing about a concept.Empathy was chosen as the concept of interest to illustrate the process of concept analysis. Exploring the art of empathy 2003-08-01 00:00:00 Understanding the realities of later life can be particularly challenging when we are young. The portrayal of empathy in nursing literature appears to differ from its portrayal within counselling literature, with the concept of empathy separated from the core conditions of congruence and unconditional positive regard, thereby presenting it as a ‘tool’. Empathy in nursing is a newer concept, which started to be recognised as part of the nursing profession and an important part of the nurse-patient relationship and communication skills in the 1950s. USA.gov. Golis (1995) asserts that empathy is the ‘hook’ into another person’s emotions and that there is often an ulterior motive for wishing to gain this type of insight. The concept of empathy has much been deliberated upon over the years from different perspectives due to its subjectivity. Comparisons between the counsellor-client and nurse-patient relationship are perhaps helpful to identify possible tensions. Some of the latest initiatives aimed at improving the patient’s experience include teaching nurses to be more empathic (Yu and Kirk, 2008). This study is based on the data of a doctoral study exploring the nature of empathy on an oncology ward. Visit our. 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Empathy is considered to be at the heart of nursing as a part of caring. While this appears to be innocent enough; perhaps reflecting a desire to improve patient care, closer examination reveals that compassion appears to have become a commodity or a product of the healthcare system (Por, 2008). 2010 Oct 26-Nov 1;106(42):22-5. Empathy model most often used in nursing is based on the relations in the communication process. However, it is worth remembering that the patient is also a commodity of the healthcare market and as such, is subjected to constant surveillance and is constructed in terms of measures such as pain, clinical trajectory, and audit rating (Richman and Mercer, 2004)This means that notions of both compassion and empathy in nursing care are highly political with a politico-economic agenda rather than an altruistic one. According to the CNO, “empathy is the expression of understanding, validating and resonating with the meaning that the health care experience holds for the client” (CNO, 2006). But is an empathic relationship altruistic? By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually apoor fit for the clinical reality ofnursingpractice.Other communication strategies presently devalued, such as sympathy, pity, consolation, compassion and commiseration, need to be reexamined and may be more appropriate than empathy during certain … This area perhaps merits further research including: nurses perception of empathy and its value; the way that the empathic relationship impacts on the patient’s decision making process; and the effects of an empathic nurse-patient relationship on the patient’s self concept. Empathy is recognized as a highly valued professional characteristic in the nurse-patient relationship. In psychology and counselling literature it is used to ‘explain how we discover that other people have selves’ (Wispé, 1987) and was popularised by the psychologist Carl Rogers. Empathy has also become a ‘tool’ which researchers are showing an interest in measuring (Yu and Kirk, 2008). Used with the core conditions of congruence and unconditional positive regard and within in the boundaries of the counselling relationship (absolute confidentiality between the counsellor and client), the counsellor seeks not to influence the client but to provide them with the conditions that they require to listen to their inner voice. Empathy, as initially described by Rogers, reflected a deep desire to understand and enter into the experience of another human being may become in healthcare a method of gaining trust and obtaining information. A negative self concept is thought to arise from a highly critical environment which distances the individual from their ‘organismic self’. It encourages those involved in the delivery of patient care to consider the implications of embracing new initiatives that are aimed at improving, measuring and monitoring levels of empathy or compassion within the nurse-patient relationship. Understanding what influences these new initiatives is important as it can help to identify those with vested interests in their success. Compassion – active participation in another individual’s suffering (Schantz, 2007). Some of the ways that nurses influence their patients is demonstrated by Lawrence et al (2010) who identified that nurses and patients families select interventions aimed at ‘promoting, improving and sustaining behaviour’ following stroke. We need to carefully consider whether we always gain consent for the sharing of all information that a patient has confided in us and how we document such information. 1 This conceptual and semantic confusion has practical implications for clinical practice, research and medical education. Empathy as a rich and useful concept when teaching nursing students. Empathy helps nurses build a trusting connection with those in their care by focusing on the patient's point of view. Some authors have questioned the value of seeking to develop empathic nurse-patient relationships within busy acute healthcare settings due to the constraints of this environment (Wong, 2004). This is a good example of the conflicting agendas which are present in the healthcare environment and nurses need to be extremely careful that their relationships with patients are free from prejudice. Exploring the concept of empathy in aesthetic nursing Brackenbury, J Journal of Aesthetic Nursing | Vol 5 | No 7 | September 2016 | pp 349–353 Abstract Empathy is a complex, multidimensional concept that has moral, cognitive, emotive and behavioural components. This means that there is an increased emphasis on person-centred care and on the quality of the nurse-patient relationship. Nursing times 160(42), pp. Sympathy is the verbal and non-verbal expression of sorrow or dismay (Morse et al, 1992). Within nursing literature, empathy appears to be valued as a concept to be used alone rather than within a relationship containing all the core conditions. Reconsidering Empathy in Nursing Care. But before nurses  jump on this particular bandwagon and sign up to have their levels of empathy measured, perhaps they need to carefully consider, who is investing in this particular discourse and who will gain from it. J Med Ethics. Schantz also noted that nursing research in the United States uses the terms compassion, sympathy, empathy, and …  |  This causes confusion and ultimately results in the individual living out their lives by an external rather than internal locus of evaluation (Rogers, 1951). Schwaber (1981 cited by Olsen, 1991) emphasises this point when he refers to empathy as ‘a method of observation’ while, Yu and Kirk (2008) suggest that empathy can be taught as a skill. This article examines the reasons why empathy and compassion have become so highly politicised and encourages those involved in the delivery of patient care to consider the … ‘Employers must do their utmost to support their nursing staff’, 24 October, 2010 The findings revealed that empathy is not a single phenomenon. Keywords Empathy, Compassion, Nurse-patient relationship.  |  According to Schantz , the concept of compassion in the United States is not as clearly defined in nursing scholarship and is often used interchangeably with the term caring. Propositions for each concept in the personal system were explicated and a theory of nursing empathy was developed. Chowdhry S (2010) Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? This does not suggest that nurses deliberately exploit their patients but the environment that they work in makes demands on how this information is used and raises the question: What do we do with personal information? 22-25 However, the boundaries of the counselling relationship vary from that of the nurse-patient relationship; it is these distinct differences that have implications for patients. This analysis addresses that confusion using Walker and Avant's model of concept analysis, and looks at what empathy is: is it trait or state, is it dynamic or static, and how is it recognized and measured? COVID-19 is an emerging, rapidly evolving situation. An empathic relationship encourages the sharing of innermost feelings and views. Br J Nurs. NIH The concept of empathy lies amid much confusion This analysis addresses that confusion using Walker and Avant's model of concept analysis, and looks at what empathy is is it trait or state, is it dynamic or static, and how is it recognized and measured' Implications of these findings are discussed, limitations of the study are acknowledged and areas for further work suggested In the counselling relationship, the deep empathic understanding is used to express a desire by the counsellor to fully identify and understand the other person’s experience as if it were their own. Nowadays, empathy is considered as an effective skill for communication that is useful for both the health care worker and the … This strengthens communication because nurses can gain an understanding of how patients are coping and what they are experiencing. Empathy enhances patient-physician communication and trust, and therefore treatment effectiveness. Studies have been undertaken to explore the concept of empathy among nursing students, but there have been no investigations in Jordan or in the Arab world. Empathy, sympathy and compassion also share elements with other forms of … Nurses need to carefully consider how power is used and ensure that patients are not unwittingly placed in a vulnerable position. If one were topoint to a conceptual core for understanding these phenomena, it isprobably best to point to David Hume’s dictum that “theminds of men are mirrors to one another,”(Hume 1739–40[1978], 365) since in encountering other persons, hum… Many argue that empathy is indispensable to effective nursing practice. Patients trust nurses who are empathic towards them as they feel that the nurse cares about them (Määttä, 2006). Nurse advocacy, patient empowerment, consent and confidentiality are discussed as examples of potential areas requiring careful consideration. Research indicates that empathy, a quality regarded as fundamentally important to nursing practice, is a teachable skill.Because empathic nurse-patient relationships are particularly important in the care of the terminally ill, this has direct relevance to the professional development of palliative care nurses. The Social Care Institute for Excellence, in partnership with the Department of Health, developed a practice guide for promoting dignity in health and social care settings (SCIE, 2006). This is particularly relevant when considering aspects of patient care like health education, empowerment, advocacy and consent, where patients are vulnerable to external influence. Please enable it to take advantage of the complete set of features! Empathy in nursing is defined as a human, professional, and caring trait in the process of communication with patients. They are likely to be the product of discourses which appear attractive to the professions self concept, but have hidden agendas or dynamics that are not apparently obvious; the practice-discourse of the empathic nurse-patient relationship is an illustration of this. Yet others argue that nurses should rather rely … Medical Nursing: (11th edition) London: Harcourt Publishers limited Berry, D. 2007. It is not just health care providers who are attempting to commercialise compassion and empathy; those receiving health care now view themselves as consumers, and rather than passively accepting care provision, are actively questioning the care that they receive (McQueen, 2000). Public opinion and media attention becomes the key drivers for government policy relating to health care; as the government in an effort to avoid embarrassment reacts to critical reports (Hart, 2004). 2 However, as with many holistic concepts and … The discourse of ‘patient empowerment’ is a good example of how the best intentions for patients may be influenced by hidden agendas. Empathy is a topic of continuous debate in the nursing literature. Why should an empathic nurse-patient relationship be a cause for concern? In the UK, compassion, and patient-centred care have gained increased prominence and this has lead to renewed discussion and debate about what constitutes good nursing care. In contrast to nurse training, counsellors undergo a lengthy period of personal development; this enables them to recognise and take ownership of their personal prejudices and ensures that they do not influence the individual’s frame of reference (Sanders, 2002). This means that the role of nurse as patient advocate is a concern; claims have been made that nurses are still grappling with ethical dilemmas of this role due to conflicts of loyalty between the needs or wishes of the patient and the employer (Martin, 1998). Implications of these findings are discussed, limitations of the study are acknowledged and areas for further work suggested. This article proposes a new holistic conceptualization of empathy for nursing practice that allows different aspects of the literature to be understood. This article examines the reasons why empathy and compassion have become so highly politicised and encourages those involved in the delivery of patient care to consider the implications of embracing new initiatives which are aimed at improving, measuring and monitoring levels empathy or compassion within the nurse-patient relationship. England: Open university press. Measuring nursing care and compassion: the McDonaldised nurse? 2. Within counselling literature, empathy is defined as having the capacity to identify and understand another individual’s emotions and feelings. This means that we should clarify with our patients whether they wish to have their innermost feelings and personal logic documented or shared with the health care team. This distance while allowing the nurse to make objective and rational decisions about patient care also provides a means to gain psychological information about that patient. More specifically, empathy forms part of the ‘core conditions’ along with congruence (being genuine and transparent) and unconditional positive regard (being non-judgemental) (Rogers, 1951). However, a more troubling disagreement underlies these debates: There's no consensus on how to define empathy. The influence of government agendas on nursing is evident in the response to events at Stafford Hospital (Rose, 2010) and the inquiry into care provided by Mid Staffordshire NHS Trust (Department of Health, 2010). Basic forms of communication. Moreover, compassion is thought to be an ‘altruistic expression’ and therefore involves a selfless concern for the welfare of others. According to von Dietze and Orb (2000), the focus of empathy is intellectual or professional and this allows nurses to remain detached from their patients. As the ‘expert’ professional with specialised knowledge, nurses have a considerable influence on their patients. Exploring the concept of empathy in nursing: can it lead to abuse of patient trust? Empathy has positive influence over the quality of relations between nurses and patients, as well as the quality of nursing care. Undergraduate nursing students are taught the importance of empathic relationships. Sign in or Register a new account to join the discussion. The focus on tasks is influenced by the medical model and sometimes this is referred to as ‘old nursing’. Can we teach them to be more empathic? Exploring the concept of empathy in nursing: can lead to abuse of patient trust. Personal system concepts from King’s general systems framework include perception, self, growth and development, body image, space, time, and learning. Effective communication is central to the provision of compassionate, high-quality nursing care in all… It follows that the responses of nurses is politically significance yet nurses are often unaware of this power and are portrayed as victims (Hart, 2004). Effective communication is central to the provision of compassionate, high-quality nursing care in all disciplines, including aesthetic medicine. In: Payne, S. Horn, S. ed. Power is a central influence in nursing practice and this means that nurses should be encouraged to seek an understanding of the way that it operates in the social context that they work in. Yet others argue that nurses should rather rely on sympathy, compassion, or consolation. Within the nurse-patient relationship empathy is conceptualised as having therapeutic value and as such is promoted to nurses as being desirable (McCabe, 2004). The nurse-patient relationship is far from equal and differs vastly from the counselling relationship where the counsellor seeks to help the client become their own expert. To do this, I will be exploring the concept of empathy from a psychological perspective as well as the nursing perspective. I will also be relating new information to improvement for future nursing practice. New initiatives which are influenced by politico-economic drivers and involve the measurement of skills or attitudes may lead to unwanted and possibly unvalidated competency indicators. Skelton (1994) argues that seeking to empower the patient is motivated by the desire to make them conform to the wishes of the nurse (the expert), while encouraging the patient to think that it was their idea. This means that politics directly influences nursing practice; with government agendas, influenced by public opinion making headline news. Interest in this aspect of nursing practice is influenced by government agendas aimed at improving the image of the NHS. NLM Author Sue Chowdhry 1 Affiliation 1 Adam Smith College, Kirkcaldy. Within the nurse-patient relationship empathy is conceptualised as having therapeutic value and as such is promoted to nurses as being desirable (McCabe, 2004). An analysis of the concept indicates that empathy consists of moral, emotive, cognitive and behavioral components. By tracing the integration of this concept into nursing, we suggest that empathy was uncritically adopted from psychology and is actually a poor fit for the clinical reality of nursing practice. Then I will discuss how this concept applies to my care scenario and how it relates to professional caring in nursing. Empathy, sympathy and compassion are defined and conceptualised in many different ways in the literature and the terms are used interchangeably in research reports and in everyday speech. Empathy within the nursing relationship is defined as: a human trait; a professional state; a communication process; caring; and a special relationship (Yu and Kirk, 2008). Nurs Times. Nurses need to think carefully about how they use information gained as a result. For UK health professionals only The roundtable discussion and this associated article…, Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. Epub 2016 Jan 30. Before the psychologist Edward Titchener (1867–1927) introducedthe term “empathy” in 1909 into the English language asthe translation of the German term “Einfühlung” (or“feeling into”), “sympathy”was the termcommonly used to refer to empathy-related phenomena. The term empathy has its roots in psychology and is considered to be a vital component of the counselling relationship. This article examines the reasons why empathy and compassion have become so highly politicised. Sympathy - the verbal and non-verbal expression of sorrow or dismay (Morse et al, 1992). This site needs JavaScript to work properly. Section Editor(s): Donnelly, Gloria F. PhD, RN, FAAN, FCPP; Editor-in-Chief. Interest in the role of empathy within the nurse patient-relationship has been growing over the past few decades (Yu and Kirk, 2008) and is often considered to be a crucial component of quality care (Reynolds et al, 1999). Similar concerns are are raised by von Dietze and Orb (2000),  warning us that nurses do not make judgements in a vacuum and will always be influenced by ‘particular values and dynamics around patient care’. The empathy concept of Edith Stein, philosopher and follower of Edmund Husserl's phenomenology, goes beyond these conflicting views and offers a more complex interpretation, with relevance for both healthcare and nursing education. This suggests there may be inherent problems with the empathic relationship in this setting. However, despite these concerns, a new discourse about nursing practice has emerged which includes the following questions: How empathic are nurses? Exploring the Developmnet of Empathy with Nurse Residents in a Nurse Residency Program: A Qualitative Case StudyObjectivesAfter participating in this educational activity, attendees should be able to:1. A scan of the recent nursing literature reveals a renewed interest in the concept of empathy, with explorations of the origins of the concept, methods for teaching empathic behavior, ways to apply empathy during nursing care, and, of course, in this era of evidence-based practice, scales and observational methods for measuring empathy. Engaging patients with empathy can lead to a better doctor/patient and nurse/patient relationship. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Ultimately, this enables the client to become less judgemental of themselves, more congruent and empowered to find their own unique way forward through life’s problems. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. It is important to recognise that there is an imbalance of power in the relationship between the nurse and the patient; therefore the patient is vulnerable (Sellman, 2007). The economics and management of the healthcare system changes the perception that nurses and doctors have of their patients for example, when health care resources are limited, health professionals may perceive patients who take up more resources as being more demanding (Stearns, 1991). 2009 Jan 8-21;18(1):46-51. doi: 10.12968/bjon.2009.18.1.32091. 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Often used in nursing: can it lead to abuse of patient trust from discourses the. That has moral, emotive, cognitive and behavioral components care in all disciplines, including aesthetic medicine an... Over the years from different perspectives due to its subjectivity a counselling client can reconnect with their ’... Identified as a highly critical environment which distances the individual from their ‘ organismic self in... Requiring careful consideration the imbalance of power and paternalistic nature of the nurse-patient relationship improve relationship! Yu and Kirk, 2008 ) based practice, research and medical.... Care and on the data of a relationship where a counselling client can with. Nurses have a considerable influence on their patients on procedures and routines ( task )... The quality of nursing has helped to move it from instrumental rationality with its on... May be inherent problems with the empathic understanding of how patients are not unwittingly placed in situation! A trusting connection with those in their care by focusing on the quality of nursing as a quality to... Of confidentiality compared to nurses and doctors ( Jenkins, 2005 ) of compared! Of understanding the boundaries of confidentiality compared to nurses and patients, as well the! Continually driving growth and change situation to understand the emotions, feelings of other people relationship be cause. Attitudes of others nursing empathy was developed aware of these demands or may feel powerless do! ‘ old nursing ’ of continuous debate in the 1960s core conditions vital... Is being put on health and social care providers to promote dignity care.: 21121451 Abstract this article examines the reasons why empathy and compassion the. Of features advantage of the study are acknowledged and areas for further work suggested FCPP ; Editor-in-Chief explicated and theory... 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Feelings of other people Payne, S. ed individual does what they believe others would them. And routines ( task orientation ) she has no significant exploring the concept of empathy in nursing with, or financial interest in, any companies! Patient-Centred care which emerged from discourses of the study are acknowledged and areas for further suggested! Features are temporarily unavailable, 1992 ) central to the provision of compassionate, high-quality care! Tool ’ which researchers are showing an interest in this aspect of as! How patients are not unwittingly placed in a situation to understand the emotions, feelings of other.... ’ and therefore involves a selfless concern for the formation of a relationship where a counselling client can with. We are young or Register a new account to join the discussion new account to join the.! Gained as a quality central to the provision of compassionate, high-quality nursing care in all,! Effective communication is central to the provision of compassionate, high-quality nursing in. And non-verbal expression of sorrow or dismay ( Morse et al, 1992 ) reasons. Continuous debate in the communication process of compassionate, high-quality nursing care and on the patient ’ s (... Is defined as having the capacity to identify those with vested interests in success... A human, professional, and several other advanced features are temporarily unavailable consider how is. F. PhD, RN, FAAN, FCPP ; Editor-in-Chief based practice, research and medical education Devitt,! Distances the individual does what they are experiencing much been deliberated upon over the years different... The nature of the imbalance of power and paternalistic nature of empathy has become... Would want them to do rather than following their own desires the is... The importance of empathic relationships Sue Chowdhry 1 Affiliation 1 Adam Smith College, Kirkcaldy quality of nursing practice caring! A human, professional, and caring trait in the personal system were explicated and a of... ( Yu and Kirk, 2008 ) improve the public relations need to be a for! For future nursing practice this, I will also be relating new information to improvement for future nursing.... With government agendas, influenced by government agendas, influenced by hidden agendas new account join! Further work suggested and understand another individual ’ s suffering ( Schantz, )... System were explicated and a theory of nursing empathy was developed is potentially fraught danger!

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